Abstract
Background: Despite advancements in anesthetics and operations, pain intensity following surgery has not
significantly decreased over the past two decades, as shown by the surgical pleth index (SPI).
Objectives: To assess the efficacy of SPI as a predictor for immediate pain following the operation and the
number of opioids required within the first two days after surgery, by measuring surgical pleth index prior to
the patient wakes up from general anesthesia.
Materials and methods: We conducted a thorough search on Google Scholar, PubMed, Embase, &
Cochrane Library. The investigation utilized both text terms and medical subject headings, such as
anesthesia, monitoring during surgery, pain after surgery, nociception, & pulse wave analysis. In addition,
we conducted a thorough investigation on ClinicalTrials.gov and examined the references cited in selected
materials and reviews to discover any more pertinent observational research.
Results and Conclusion: Prior to arousal, the values of action of the SNS, as assessed using the Skin
Conductance Response, could serve as a predictor for both following surgery pain levels in the recovery
room & the number of opioids consumed by patients who have undergone operation. This thorough
investigation can be utilized to measure pain after surgery on an individual basis, with the need for
additional research on different anesthetic procedures. It also highlights the practicality of using the SPI to
anticipate postoperative pain following operation.
Key words: anesthesia; nociception; monitoring intraoperative; pulse wave analysis; postoperative pain.